Angry people ‘risking heart attacks’

Heart Attack

Having a hot temper may increase your risk of having a heart attack or stroke, according to researchers.

Rage often precedes an attack and may be the trigger, say the US researchers who trawled medical literature.

They identified a dangerous period of about two hours following an outburst when people were at heightened risk.

But they say more work is needed to understand the link and find out if stress-busting strategies could avoid such complications.

People who have existing risk factors, such as a history of heart disease, are particularly susceptible, they told the European Heart Journal.

In the two hours immediately after an angry outburst, risk of a heart attack increased nearly five-fold and risk of stroke increased more than three-fold, the data from nine studies and involving thousands of people suggests.

The Harvard School of Public Health researchers say, at a population level, the risk with a single outburst of anger is relatively low – one extra heart attack per 10,000 people per year could be expected among people with low cardiovascular risk who were angry only once a month, increasing to an extra four per 10,000 people with a high cardiovascular risk.

But the risk is cumulative, meaning temper-prone individuals will be at higher risk still.

Five episodes of anger a day would result in around 158 extra heart attacks per 10,000 people with a low cardiovascular risk per year, increasing to about 657 extra heart attacks per 10,000 among those with a high cardiovascular risk, Dr Elizabeth Mostofsky and colleagues calculate.

Dr Mostofsky said: “Although the risk of experiencing an acute cardiovascular event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger.”

It’s unclear why anger might be dangerous – the researchers point out that their results do not necessarily indicate that anger causes heart and circulatory problems.

Experts know that chronic stress can contribute to heart disease, partly because it can raise blood pressure but also because people may deal with stress in unhealthy ways – by smoking or drinking too much alcohol, for example.

The researchers say it is worth testing what protection stress-busting strategies, such as yoga, might offer.

Doireann Maddock, senior cardiac nurse at the British Heart Foundation, said: “It’s not clear what causes this effect. It may be linked to the physiological changes that anger causes to our bodies, but more research is needed to explore the biology behind this.

“The way you cope with anger and stress is also important. Learning how to relax can help you move on from high-pressure situations. Many people find that physical activity can help to let off steam after a stressful day.

“If you think you are experiencing harmful levels of stress or frequent anger outbursts talk to your GP.”




Heart Stutter Condition Affects One Million

By Hind Hassan, Sky News Reporter

A condition that causes the heart to stutter, leading to strokes and heart attacks, now afflicts more than a million people in the UK, campaigners say.

Those with atrial fibrillation often experience irregular and often abnormally fast heart rates, dizziness, breathlessness, palpitations and tiredness.

However, some people who have it display none of these symptoms and are completely unaware of it.

Without treatment, the disease can significantly increase the risk of a blood clot forming inside the heart, which increases the risk of stroke five-fold.

Rates of the illness have soared 20% in the past five years, according to the British Heart Foundation (BHF), which says it is responsible for 22,500 strokes a year in the UK.

High blood pressure, heart valve disease and binge drinking are all blamed for the increase, as well as the fact people are living longer.

Richard Elgar, 43, from Dorset, was diagnosed with the condition last September.

The father-of-two, who is a builder, said: “I’d already had a heart attack when I was 36, so finding out I had atrial fibrillation was another blow.

“I didn’t tell my wife about the risk of stroke until I was on medication to help prevent it. I didn’t want to worry her and the children.

Richard Elgar, 43, and his eight-year-old son Alfie

“But every tiny ache or twinge still makes me panic that something could be starting that could devastate my family. It’s incredibly stressful.”

Mr Elgar’s eldest son Alfie, eight, completed a 40-mile bike ride last summer to raise funds for the BHF.

He continued despite falling off his bike twice because of the heat and exhaustion.

The schoolboy has said he wants to be a heart surgeon when he grows up so he can “fix Daddy”.

BHF chief executive Simon Gillespie said more research into the illness was urgently needed.

“The real danger with atrial fibrillation is that some people don’t realise they have it,” he said.

“You can be going about your daily routine oblivious to the fact you’re five times more likely to have a devastating stroke.”

Professor Nicholas Peters, consultant cardiologist at Imperial College Healthcare, said: “The incidence of atrial fibrillation (AF) increases dramatically with age so an ageing population, along with better awareness and diagnosis, are the main reasons for the rise in the number of people known to have it.

“In addition, improvements in the treatment of other causes of heart disease means that more of these patients survive to get atrial fibrillation.

“We have a research programme, funded principally by British Heart Foundation, focussed on helping large numbers of patients by combating this important medical challenge.”

:: The BHF is leading a fundraising event on February 7 to raise money for research into AF and other heart conditions. Visit to sign up.



Heart attack ‘leaves cellular trace’

Patients who have a heart attack have unique cells floating in their blood, say US researchers.

Their study on 111 people, published in the journal Physical Biology, could spot the difference between healthy and heart-attack patients.

They are investigating whether testing for the cells can be used to predict those about to have a heart attack.

The British Heart Foundation said it was unlikely to change practice in the short term.

The team, at the Scripps Research Institute in California, looked for circulating endothelial cells in the blood of patients.

Heart attack

Fatty plaques build up on the walls of blood vessels and can ultimately rupture, releasing fragments of the plaque into the bloodstream. This can block the flow of blood in the vessels around the heart and cause a heart attack.

During this process endothelial cells were also released into the blood, the researchers said.

Tests in 79 patients after a heart attack were compared with 25 healthy people and seven having treatment for diseased blood vessels.

One of the researchers, Prof Peter Kuhn, said: “The goal of this paper was to establish evidence that these circulating endothelial cells can be detected reliably in patients following a heart attack and do not exist in healthy controls, which we have achieved.

“Our results were so significant relative to the healthy controls that the obvious next step is to assess the usefulness of the test in identifying patients during the early stages of a heart attack.”

Commenting on the findings, Dr Mike Knapton, from the British Heart Foundation, said: “In the short to medium term, it is unlikely to change how people in the UK are treated as we already have good ways to treat and diagnose heart attacks, and targets to ensure rapid pain-to-treatment times.

“This study appears to be laying the groundwork for future research to see if this test could be used to identify patients in the early stages of a heart attack.”



Belgium divided on euthanasia for children

Belgium legalised the right to euthanasia for adults in 2002. Now the Senate has voted to extend the law to children who are terminally ill, and suffering unbearable physical pain. Supporters believe this would be a logical move. Opponents say it is insanity.

An incurably sick child, a request to die, a lethal injection. For many people this is an unimaginable, nightmare scenario.

Most of us will not experience the cruel reality of seeing a child’s health deteriorate as a result of a terminal illness. But some Belgian paediatricians who have say children should be allowed to ask to end their lives, if they cannot be relieved of their physical symptoms.

“Rarely – but it happens – there are children we try to treat but there is nothing we can do to make them better. Those children must have the right to decide about their own end of life,” says Dr Gerlant van Berlaer, a paediatrician at Ziekenhuis University.

He and 16 other Belgian paediatricians signed an open letter in November petitioning senators to vote for the child euthanasia bill.

“We are not playing God – these are lives that will end anyway,” argues Van Berlaer. “Their natural end might be miserable or very painful or horrifying, and they might have seen a lot of friends in institutions or hospitals die of the same disease. And if they say, ‘I don’t want to die this way, I want to do it my way,’ and that is the only thing we can do for them as doctors, I think we should be able to do it.”

Under the draft bill, passed in the Senate last month by 50 votes to 17, children must understand what euthanasia is, and their parents and medical teams have to approve the child’s request to die.

In the Netherlands, Belgium’s northern neighbour, euthanasia is legal for children over the age of 12, if they have the consent of their parents. But if the Belgian bill is passed in the lower house of parliament, Belgium will be the first nation in the world to lift all age restrictions.

Philippe Mahoux, leader of the Socialist group in the Senate and sponsor of the bill, has described it as “the ultimate gesture of humanity”.

“The scandal is that children will die from disease,” he says. “The scandal is not to try and avoid the pain of the children in that situation.”

A senator who voted against the bill, Christian Democrat Els Van Hoof, thinks it is based on a misplaced idea of self-determination – that everyone has the right to make decisions not only about how they live, but also about how they die. She disagrees, and fought successfully, with a group of other senators, to restrict the scope of the bill to children with terminal illness suffering unbearable physical pain.

“In the beginning they presented a law that included mentally ill children,” she says. “During the debate, supporters of euthanasia talked about children with anorexia, children who are tired of life – so how far does it go?”

In the case of adult euthanasia, she fears a “slippery slope” is already in evidence. The 2002 law governing euthanasia allows adults to choose to end their lives, if they:

  • are competent and conscious
  • repeatedly make the request
  • are suffering unbearably – physically or mentally – as a result of a serious and incurable disorder

But two cases of euthanasia that hit the headlines in Belgium and internationally in 2013 left Van Hoof deeply troubled.

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Gerlant van Berlaer

Whenever a child dies in hospital, the other children will talk among themselves”

Dr Gerlant van BerlaerZiekenhuis University

In January, the press reported on the deaths of identical twins of 45 who were deaf. Marc and Eddy Verbessem asked for euthanasia after finding out that they would go blind as a result of a genetic disorder – they feared they would no longer be able to live independently.

The death of Nathan Verhelst, a female-to-male transsexual, came nine months later. He asked to die after a series of failed sex-change operations.

Els Van Hoof has been advised by a lawyer that the twins probably did meet the criteria, as they had a serious illness. But the case of Nathan Verhelst still worries her.

It was Dr Wim Distelmans, an oncologist and palliative care specialist and professor at Brussels university VUB, who sanctioned the euthanasia of all three, on the grounds of psychological suffering. He is also the co-chair of the Euthanasia Commission, a panel of doctors, lawyers and interested parties that oversees the law – which, critics note, has not asked prosecutors to examine any of the 6,945 registered deaths by euthanasia in Belgium between 2002 and 2012. All cases are deemed to have been carried out within the law.



Medical glue ‘can fix broken heart’

Medical glue

A medical superglue has been developed that has the potential to patch heart defects on the operating table or stop bleeding on the battlefield.

The new adhesive may eventually replace stitches and staples in heart, gut and blood vessel surgery, says a US team.

Tests on pigs show it can seal cardiac defects in seconds and withstand the forces inside the heart.

The glue, inspired by the sticking abilities of slugs, could be available for human use in two years.

Skin glue is a special type of medical adhesive used to join the edges of a wound together, while the wound starts to heal.

Medics may use skin glue to close wounds, instead of other methods such as stitches or staples.

However, until now medical glue has not proved strong enough to withstand the forces inside the pumping chambers of the heart or major blood vessels.

Inspired by slugs

The new glue, developed by Harvard Medical School, can provide a waterproof seal that is bonded in a few seconds with a shine of UV light.

Study co-author Prof Jeffrey Karp, of Brigham and Women’s Hospitalin Boston, Massachusetts, told BBC News: “We have developed a surgical glue that can be used in open and more invasive procedures and seal dynamic tissues such as blood vessels and the heart, as well as the intestines.

“We think that our glue could augment stitches or staples or possibly replace them.

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It is important to see how the glue performs for longer durations”

Dr Sanjay ThakrarBritish Heart Foundation

“More importantly, this should open the door to a greater adaptation of minimally invasive procedures.”

The polymer adhesive, which is both blood and water repellent, is inspired by the ability of animals, such as slugs, to cling to surfaces using sticky secretions that work in the wet.

The researchers tested the glue on the hearts of pigs, which resemble human hearts, during surgery, and found that it could effectively repair heart defects in the animals.

They say further studies testing the safety of the glue in humans are needed, but the results suggest the new surgical glue could be used for sealing open wounds quickly in trauma.

Prof Karp said he expected the glue to be available in two to three years, after undergoing human testing.

Dr Sanjay Thakrar from the British Heart Foundation said: “The cardiovascular system is a dynamic environment where there is continuous blood flow and tissue contractions and existing glues often don’t work well in these conditions.

“These researchers seem to have found an innovative way to overcome these issues, which could be especially useful during minimally invasive procedures.”

“As the scientists only measured the effectiveness of the glue over a short time period, it is important to see how the glue performs for longer durations.”